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Is there an association between Helicobacter pylori infection and irritable bowel syndrome? A meta-analysis.
World J Gastroenterol. 2019 Oct 07; 25(37):5702-5710.WJ

Abstract

BACKGROUND

Irritable bowel syndrome (IBS) is a prevalent and debilitating gastrointestinal condition. Research has reported persistent, low-grade mucosal inflammation and significant overlaps between patients with IBS and those with dyspepsia, suggesting a possible pathogenic role of Helicobacter pylori (H. pylori) in IBS. This study therefore aimed to provide the first systematic review and meta-analysis on the association between H. pylori infection and IBS.

AIM

To investigate the association between H. pylori infection and IBS.

METHODS

Using the keywords "H. pylori OR Helicobacter OR Helicobacter pylori OR infection" AND "irritable bowel syndrome OR IBS", a preliminary search of PubMed, Medline, Embase, Cochrane Database of Systematic Reviews, Web of Science, Google Scholar and WanFang databases yielded 2924 papers published in English between 1 January 1960 and 1 June 2018. Attempts were also made to search grey literature.

RESULTS

A total of 13 clinical studies were systematically reviewed and nine studies were included in the final meta-analysis. Random-effects meta-analysis found a slight increased likelihood of H. pylori infection in patients with IBS, albeit this was not statistically significant (pooled odds ratio 1.47, 95% confidence interval: 0.90-2.40, P = 0.123). It must also be acknowledged that all of the available studies reported only crude odd ratios. H. pylori eradication therapy also does not appear to improve IBS symptoms. Although publication bias was not observed in the funnel plot, there was a high degree of heterogeneity amongst the studies included in the meta-analysis (I 2 = 87.38%).

CONCLUSION

Overall, current evidence does not support an association between IBS and H. pylori infection. Further rigorous and detailed studies with larger sample sizes and after H. pylori eradication therapy are warranted.

Authors+Show Affiliations

Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore.Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore.Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore.Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore.Medicine, MOH Holdings Pte Ltd, Singapore 099253, Singapore.Department of Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore 119074, Singapore.Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

31602169

Citation

Ng, Qin Xiang, et al. "Is There an Association Between Helicobacter Pylori Infection and Irritable Bowel Syndrome? a Meta-analysis." World Journal of Gastroenterology, vol. 25, no. 37, 2019, pp. 5702-5710.
Ng QX, Foo NX, Loke W, et al. Is there an association between Helicobacter pylori infection and irritable bowel syndrome? A meta-analysis. World J Gastroenterol. 2019;25(37):5702-5710.
Ng, Q. X., Foo, N. X., Loke, W., Koh, Y. Q., Seah, V. J. M., Soh, A. Y. S., & Yeo, W. S. (2019). Is there an association between Helicobacter pylori infection and irritable bowel syndrome? A meta-analysis. World Journal of Gastroenterology, 25(37), 5702-5710. https://doi.org/10.3748/wjg.v25.i37.5702
Ng QX, et al. Is There an Association Between Helicobacter Pylori Infection and Irritable Bowel Syndrome? a Meta-analysis. World J Gastroenterol. 2019 Oct 7;25(37):5702-5710. PubMed PMID: 31602169.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is there an association between Helicobacter pylori infection and irritable bowel syndrome? A meta-analysis. AU - Ng,Qin Xiang, AU - Foo,Nadine Xinhui, AU - Loke,Wayren, AU - Koh,Yun Qing, AU - Seah,Vanessa Jing Min, AU - Soh,Alex Yu Sen, AU - Yeo,Wee Song, PY - 2019/05/29/received PY - 2019/07/30/revised PY - 2019/09/09/accepted PY - 2019/10/12/entrez PY - 2019/10/12/pubmed PY - 2020/2/27/medline KW - Functional KW - Helicobacter pylori KW - Infection KW - Irritable bowel syndrome KW - Meta-analysis SP - 5702 EP - 5710 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 25 IS - 37 N2 - BACKGROUND: Irritable bowel syndrome (IBS) is a prevalent and debilitating gastrointestinal condition. Research has reported persistent, low-grade mucosal inflammation and significant overlaps between patients with IBS and those with dyspepsia, suggesting a possible pathogenic role of Helicobacter pylori (H. pylori) in IBS. This study therefore aimed to provide the first systematic review and meta-analysis on the association between H. pylori infection and IBS. AIM: To investigate the association between H. pylori infection and IBS. METHODS: Using the keywords "H. pylori OR Helicobacter OR Helicobacter pylori OR infection" AND "irritable bowel syndrome OR IBS", a preliminary search of PubMed, Medline, Embase, Cochrane Database of Systematic Reviews, Web of Science, Google Scholar and WanFang databases yielded 2924 papers published in English between 1 January 1960 and 1 June 2018. Attempts were also made to search grey literature. RESULTS: A total of 13 clinical studies were systematically reviewed and nine studies were included in the final meta-analysis. Random-effects meta-analysis found a slight increased likelihood of H. pylori infection in patients with IBS, albeit this was not statistically significant (pooled odds ratio 1.47, 95% confidence interval: 0.90-2.40, P = 0.123). It must also be acknowledged that all of the available studies reported only crude odd ratios. H. pylori eradication therapy also does not appear to improve IBS symptoms. Although publication bias was not observed in the funnel plot, there was a high degree of heterogeneity amongst the studies included in the meta-analysis (I 2 = 87.38%). CONCLUSION: Overall, current evidence does not support an association between IBS and H. pylori infection. Further rigorous and detailed studies with larger sample sizes and after H. pylori eradication therapy are warranted. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/31602169/Is_there_an_association_between_Helicobacter_pylori_infection_and_irritable_bowel_syndrome_A_meta_analysis_ L2 - https://www.wjgnet.com/1007-9327/full/v25/i37/5702.htm DB - PRIME DP - Unbound Medicine ER -